PURPOSE: Comorbid conditions have become increasingly relevant for breast cancer care given the large numbers of long-term survivors. Our aim was to identify potential determinants associated with the development of comorbidities after breast cancer. METHODS: Self-reported comorbidities and lifestyle were assessed at recruitment and after a median follow up of 69.4 months from diagnosis in a population-based cohort of breast cancer cases aged 50 to 74 years at diagnosis (MARIEplus study). Tumor and therapy data were extracted from medical records. Determinants potentially associated with incident diagnoses of hypertension, cardiovascular diseases (CVD), and osteoporosis were assessed using multivariable Cox proportional hazard regression models. RESULTS: Follow-up interview was completed by 2,542 women (76.4 % of eligible patients). A diagnosis of hypertension was significantly associated with age, higher education (hazard ratio (HR) 0.54, CI 0.37-0.79), baseline body mass index (BMI; ≥30 kg/m(2); HR, 1.90; CI, 1.24-2.90), and trastuzumab medication (HR, 2.16; CI, 1.09-4.33). An increased risk for CVD was associated with age, BMI, and intake of aromatase inhibitors (AI; HR, 1.42; CI, 1.09-1.84). Risk of osteoporosis was also positively associated with AI treatment (HR, 2.15; CI, 1.64-2.82) but inversely associated with a higher BMI (≥30 kg/m(2); HR, 0.50; CI, 0.31-0.79). CONCLUSION: In breast cancer survivors, treatment with AI constituted a risk factor for incident CVD and osteoporosis. Besides known risk factors, patients who were treated with trastuzumab may have an increased risk for hypertension. IMPLICATIONS FOR CANCER SURVIVORS: Reducing overweight and regular sport/cycling activities may help to prevent CVD after breast cancer. Patients should be monitored for risk factors and advised on possible cardiac side effects of AI and trastuzumab.
PURPOSE: Comorbid conditions have become increasingly relevant for breast cancer care given the large numbers of long-term survivors. Our aim was to identify potential determinants associated with the development of comorbidities after breast cancer. METHODS: Self-reported comorbidities and lifestyle were assessed at recruitment and after a median follow up of 69.4 months from diagnosis in a population-based cohort of breast cancer cases aged 50 to 74 years at diagnosis (MARIEplus study). Tumor and therapy data were extracted from medical records. Determinants potentially associated with incident diagnoses of hypertension, cardiovascular diseases (CVD), and osteoporosis were assessed using multivariable Cox proportional hazard regression models. RESULTS: Follow-up interview was completed by 2,542 women (76.4 % of eligible patients). A diagnosis of hypertension was significantly associated with age, higher education (hazard ratio (HR) 0.54, CI 0.37-0.79), baseline body mass index (BMI; ≥30 kg/m(2); HR, 1.90; CI, 1.24-2.90), and trastuzumab medication (HR, 2.16; CI, 1.09-4.33). An increased risk for CVD was associated with age, BMI, and intake of aromatase inhibitors (AI; HR, 1.42; CI, 1.09-1.84). Risk of osteoporosis was also positively associated with AI treatment (HR, 2.15; CI, 1.64-2.82) but inversely associated with a higher BMI (≥30 kg/m(2); HR, 0.50; CI, 0.31-0.79). CONCLUSION: In breast cancer survivors, treatment with AI constituted a risk factor for incident CVD and osteoporosis. Besides known risk factors, patients who were treated with trastuzumab may have an increased risk for hypertension. IMPLICATIONS FOR CANCER SURVIVORS: Reducing overweight and regular sport/cycling activities may help to prevent CVD after breast cancer. Patients should be monitored for risk factors and advised on possible cardiac side effects of AI and trastuzumab.
Authors: A Buzdar; A Howell; J Cuzick; C Wale; W Distler; G Hoctin-Boes; J Houghton; G Y Locker; J M Nabholtz Journal: Lancet Oncol Date: 2006-08 Impact factor: 41.316
Authors: Henning Mouridsen; Aparna Keshaviah; Alan S Coates; Manuela Rabaglio; Monica Castiglione-Gertsch; Zhuoxin Sun; Beat Thürlimann; Louis Mauriac; John F Forbes; Robert Paridaens; Richard D Gelber; Marco Colleoni; Ian Smith; Karen N Price; Aron Goldhirsch Journal: J Clin Oncol Date: 2007-11-12 Impact factor: 44.544
Authors: Edward H Romond; Jong-Hyeon Jeong; Priya Rastogi; Sandra M Swain; Charles E Geyer; Michael S Ewer; Vikas Rathi; Louis Fehrenbacher; Adam Brufsky; Catherine A Azar; Patrick J Flynn; John L Zapas; Jonathan Polikoff; Howard M Gross; David D Biggs; James N Atkins; Elizabeth Tan-Chiu; Ping Zheng; Greg Yothers; Eleftherios P Mamounas; Norman Wolmark Journal: J Clin Oncol Date: 2012-09-17 Impact factor: 44.544
Authors: Beatriz Isidoro; Virginia Lope; Carmen Pedraz-Pingarrón; Francisca Collado-García; Carmen Santamariña; Pilar Moreo; Carmen Vidal; María Soledad Laso; Milagros García-Lopez; Marina Pollán Journal: BMC Public Health Date: 2011-12-30 Impact factor: 3.295
Authors: Eva Lorenz; Maria Blettner; Björn Lange; Marcus Schmidt; Astrid Schneider; Lukas Schwentner; Daniel Wollschläger; Hiltrud Merzenich Journal: Breast Care (Basel) Date: 2018-03-29 Impact factor: 2.860